Intestinal irrigation device and method of using the device

ABSTRACT

An intestinal irrigation device that includes a waste collection bag and a rectal catheter. The rectal catheter has a first end for coupling with the waste collection bag and a free end for insertion into the rectum, while the waste collection bag has a first wall circumferentially united with an opposing second wall and an inlet opening for irrigated waste. The inlet opening has a first coupling part for coupling the rectal catheter into fluid communication with the bag, and the bag has a second coupling part inside it for mating the first coupling part. The device provides a time saving alternative to known devices, and no odor emissions and unpleasant smell is recognized during the irrigation procedure.

The present invention relates to an intestinal irrigation devicecomprising a waste collection bag and a rectal catheter, the rectalcatheter has a first end for coupling with the waste collection bag anda free end for insertion into the rectum, the waste collection bag has afirst wall circumferentially united with an opposing second wall and aninlet opening for irrigated waste.

The rectum is a temporary storage for faeces. As the rectal walls expanddue to the materials filling it from within the desire to defecateincreases. Peristaltic movements forces the faeces out of the rectum andthe sphincter allows the faeces to pass out. If defecation for somereason is not attended to the faeces stays in the colon where more wateris absorbed resulting in that the faeces hardens. This condition can beextremely painful, and can in severe cases involve fecal impaction,bowel obstruction and obstipation. Also paradoxical diarrhea where softstool from the small intestine bypasses the impacted stool is seen as amajor problem for many people.

A number of people are not able to move onto a toilet to defecate. Thereasons for this may e.g. be traumas, deceases, age, or they may benewly operated. For example spinal cord injury patients requireassistance when defecating. For these groups of bedridden peopledefecation is preformed laying in bed either as an unplanned event orhelped by caring staff using various means for facilitating evacuation.These means can be a combination of stimulation, laxatives,suppositories, or other medical interventions or pure mechanicalevacuation.

In summary many people have problems defecating e.g. due to theirdigestive system being constipated, because they are bedridden, orcombinations of these conditions.

Enemas has been used since ancient times for aiding people evacuatingtheir intestines. An irrigation liquid is administered to theintestines, preferably both the rectum and colon, via the anus. Theirrigation liquid softens the hard faeces so it is able to evacuatesuspended in the administered irrigation liquid.

In any of the above referred situations including having difficulties indefecation and suffering from involuntary defecation, e.g. encopresis,people may benefit from aided defecation.

A conventional transanal irrigation device consists of a siliconecatheter provided with an inflatable balloon. The catheter is introducedin the rectum and the baloon is inflated to keep the catheter fixedinside the rectum, and further to prevent leakage via the anal canalduring the subsequent irrigation. The faecal matter subsequentlyevacuated from the patient is collected in a bedpan or spills into thebed sheets or absorbent matter, such as towels, single use absorbentsheets, etc. This procedure is time consuming, not dignifying forneither the caring person nor the patient, it soils the environment bothwith irrigated matter and unpleasant smell and the patient needs washingafterwards.

New more hygienic and dignifying solutions for performing variousdegrees of intestinal irrigation are in great demand.

It is a main aspect according to the present invention to provide anovel intestinal irrigation device of the kind mentioned in the openingparagraph that makes it possible to perform intestinal irrigationwithout the patient and the surroundings getting soiled.

In a second aspect according to the present invention is provided anintestinal irrigation device of the kind mentioned in the openingparagraph that is closeable and easy to dispose after use.

In a third aspect according to the present invention is provided anintestinal irrigation device of the kind mentioned in the openingparagraph that is inexpensive to manufacture and is simple and reliableto use.

The novel and unique whereby this is achieved is the fact that the inletopening has a first coupling part for coupling the rectal catheter intofluid communication with the waste collection bag, and the wastecollection bag has a second coupling part inside the waste collectionbag for mating the first coupling part.

In the first step of an irrigation procedure the irrigation liquid isinfused to the intestinal organs which need aided evacuation. Theirrigation liquid softens hard matter inside at least the rectum and thelower colon and the irrigation liquid including suspended and/orsoftened matter can expediently be evacuated and collected into thewaste collection bag through the inlet opening in the waste collectionbag. The first coupling part, which is arranged at the inlet opening,serves both as a reliable securing means for the rectal catheter and forreceiving the second coupling part during infusing the irrigation liquidand after completion of the evacuation and termination of theirrigation. The second coupling part is inserted into the first couplingpart both when the irrigation liquid is infused to the intestine andagain after completion of evacuation of the infused irrigation liquid.No unpleasant smells and soiling accompany this novel very discreteirrigation procedure.

In an embodiment which is especially simple to manufacture and use, theinlet opening may be provided in the second wall, i.e. the wall facingtowards the patient during the irrigation procedure, and the secondcoupling part may protrude inside the waste collection bag from thefirst wall, i.e. the wall farthest from the patient and accessibleduring the irrigation procedure, substantially opposite the inletopening. When the second coupling part faces the first coupling part themating of these parts are particular easy to perform, in particularafter termination of the irrigation where the waste collection bag isfull of irrigated matter.

Preferably the first coupling part is a hollow tubular first couplingpart having a part designed to receive the rectal catheter, which partfits into or surrounds an annular part of a second coupling part whichis operable from outside the waste collection bag to mate and/or engagewith the female tubular first coupling part.

Within the scope of the present invention the hollow first coupling partand the second coupling part may be given any appropriate complementarydesigns, which provide for mating of the parts to obtain closure and/orsealing of the empty waste collection bag during infusion of irrigationliquid and of the full waste collection bag after the rectal catheterhas been removed from its position inside the rectum followingirrigation. The first coupling part can for example be made as a femalecylindrical connecting piece or connecting pipe extending through thewall of the waste collection bag or protruding from the exterior wall,and the second coupling part may be complementary shaped as a solid orhollow male blind plug. Alternatively, the first coupling part and thesecond coupling part may be designed with snap fitting means such asannular key and slot, or vice versa, or the second coupling part may fitaround the exterior diameter of a part of the first coupling partprotruding a short distance inside the waste collection bag. The rectalcatheter, a coupling end of which may be annularly inserted between theoverlapping parts of the first coupling part and the second couplingpart, may provide annular sealing depending on dimensioning of thediameters of the coupling parts and the catheter.

If the rectal catheter is detachable attached to the first coupling partthe rectal catheter can be inserted as a separate part which also iseasy to detach when the closed waste collection bag are to be disposed.If desired or required for sealing the rectal catheter can remain on theclosed waste collection bag to be jointly disposed off.

In an advantageously embodiment according to the present invention therectal catheter is configured as a dimensionally stable, tubularstructure which has an inlet opening for infusing the irrigation liquid.The dimensionally stable structure advantageously keeps the rectumdistended during the period the rectal catheter is inserted. Thesphincter clamps in a tight fitting manner around the exterior face ofthe non-collapsible rectal catheter and provides a sealing capacity thatfor a normal functioning sphincter is sufficient to prevent leakage. Dueto the dimensional stability of the rectal catheter the rectal catheterdoes not collapse in response to peristaltic movements and/or intestinalforce and a free flow pathway is sustained both during infusion ofirrigation liquid and during the subsequent evacuation of waste. Noballoon is required for keeping the intestines distended and in place asin conventional devices for performing irrigations. The internaldiameter of the intestinal canal around the rectal catheter is kept openand substantially constant by the dimensionally stable structure of therectal catheter itself. Moreover, the dimensionally stable structuredoes not curl up or kink during insertion into the rectum as is the riskwhen using conventional flexible rubber or plastic catheters.

In order to preform a gentle, less painful and anatomical moreacceptable insertion the rectal catheter may be given a tapered free endopposite the end which is designed for engaging the first and/or secondcoupling part of the waste collection bag.

The diameter of the rectal catheter may vary in dependency of anatomicalconditions. A child may require a short rectal catheter having a smallexternal diameter contrary to an adult, which is able to accept largerexternal diameters inside the rectum. Alternatively a catheter having acone-shaped end may be preferred. The length, external diameter,internal diameter and degree of tapering towards the free end of therectal catheter are selected in dependency of the required use and theanatomical conditions of the patient. Various standard dimensionproducts and individual combination of rectal catheters and wastecollection bags of different sizes are foreseen within the scope of thepresent invention allowing the patient to select exactly the combinationsuitable for her/his specific need. Irrespective of choice of wastecollection bag or rectal catheter it is preferred that the firstcoupling part of the waste collection bag and the coupling end of therectal catheter are made as standard units to allow a plurality ofcombinations of bags and rectal catheters. Preferably the sealingbetween the rectal catheter and the first coupling part is leak proofedboth in the situation where the second coupling part is engaged with thefirst coupling part, and in the situation where these coupling parts aredisengaged.

The insertion may cause considerable inconvenience to the patient andpreferably an introducer may be used for facilitating a gentleinsertion. The introducer may e.g. have a pointed blunt tip to aid inalleviating the physical discomfort and pain that the patient may expireduring insertion of the rectal catheter.

In a second modified embodiment according to the present invention theintroducer has a guide rod, which extends displaceable through thesecond coupling part with the tip of the introducer located inside thebag. The introducer is in this embodiment not a separate part but can bemoved in and out of the catheter so that the tip protrudes from thecatheter end and the catheter can be smoothly and gently inserted intothe rectum. The tip of the introducer may be dimensioned so that the tipalso can serve as a seal inside the catheter. This second embodiment maybe very fast to operate and may be preferred for children.

The intestinal irrigation device according to the present invention canbe used in a method comprising the steps of inserting the rectalcatheter in the rectum, mating the coupling parts to at leastsubstantially close the waste collection bag, mounting the substantiallyclosed waste collection bag on the rectal catheter, infusing theirrigation liquid to at least the rectum intestine, disengaging thefirst coupling part and the second coupling part, draining theirrigation liquid and irrigated intestinal content into the wastecollection bag, removing the rectal catheter from the rectum, engagingthe second coupling part and the first coupling part to close the inletopening of the waste collection bag.

In the above method the rectal catheter may be detached from the closedwaste collection bag before disposal in order to meet demands on wasteclassification for disposal and incineration.

The invention will be explained in greater detail below, describingexemplary embodiments of the intestinal irrigation device with referenceto the drawing, in which

FIG. 1 shows a perspective exploded view of the components for anexemplary embodiment of an intestinal irrigation device according to thepresent invention and an introducer for the device,

FIG. 2 is a perspective view of the introducer inserted into a detachedrectal catheter,

FIG. 3 shows a perspective view of the waste collection bag and therectal catheter for the intestinal irrigation device according to theinvention,

FIG. 4 shows a perspective view of the waste collection bag and therectal catheter in assembled state, ready for infusing the irrigationliquid,

FIG. 5 shows the waste collection bag during and after evacuation ofirrigated matter, where the first coupling part and the second couplingpart are disengaged,

FIG. 6 shows the intestinal irrigation device after the irrigation hasbeen terminated, the waste collection bag has been closed, and therectal catheter has been detached,

FIG. 7 shows in an enlarged scale an axial, sectional view of a firstway of engaging a first coupling, a second coupling part and a rectalcatheter,

FIG. 8 shows in an enlarged scale an axial, sectional view of a secondway of engaging a first coupling part, a second coupling part and arectal catheter, and

FIG. 9 shows a sectional view of a second embodiment intestinalirrigation device according to the present invention.

The invention is described below with the assumption that the intestinalirrigation device is used in a transanal irrigation (TAI) procedure.This assumption is not to be construed as limiting, and other morethorough irrigation procedures can also be performed using the deviceaccording to the present invention.

In the perspective exploded view of FIG. 1 the components for theintestinal irrigation device 1 is seen together with and introducer 2.

The intestinal irrigation device 1 consist basically of a wastecollection bag 3 and a rectal catheter 4.

The waste collection bag 1 is constructed of a first wall 5, facing awayfrom the patient during irrigation, and an opposing second wall 6,facing towards the patient during irrigation. By way of example thewalls 5,6 are in the following description indicated as beingtransparent (seen through) to better illustrate the assembling of thevarious components belonging to the device 1. Transparency is howeveroptional, but allows monitoring of draining and evacuation, and visualinspection of the evacuated matter.

The first wall 5 has a male second coupling part 7 for engaging a femalefirst coupling part 8 arranged at the inlet opening 9 of the second wall6.

The second coupling part 7 has a male part 10 protruding inside thewaste collection bag 3 towards the female first coupling part 8. Themale part 10 extends into a grip 11 outside the waste collection bag 3so that the second coupling part 7 traverses or is coupled to the firstwall 5 in a sealingly manner, enabling the second coupling part 7 to beinserted into and retracted from the bore 12 of the first coupling part8 from outside the waste collection bag 3. The male part 10 of thesecond coupling part 7 has in the case shown an annular sealing rim 13.The second coupling part 7 is attached to the first wall 5 by means ofan annular attachment part 14 between the male part 10 and the grip 11.

The female first coupling part 8 consists of a securing flange 15secured to the inlet opening 9 in the second wall 6. The securing flange15 extends into a tubular connection piece 16 protruding outside thewaste collection bag 3 when the first wall 5 and the second wall 6 areunited to form the waste collection bag 3. The bore 12 of the tubularconnection piece 16 serves for receiving the male part 10 of the secondcoupling part 7 when the entire device 1 is to be operated. Thecircumference 17 of the first wall 5 and the circumference 18 of thesecond wall 6 are united, e.g. using high frequency welding, heatsealing, ultra sonic welding, laser welding or gluing to form the wastecollection bag 3. This waste collection bag may e.g. be made of atransparent disposable plastic material such as polyethylene (PE) orethylene vinyl acetate (EVA), both of which can be incinerated in aninexpensive manner together with usual hospital waste. Also polyvinylchloride can be used. In case the patient expires the irrigationprocedure as particular unaesthetic and prefers to have a very discretedisposal of the waste, the waste collection bag may be coloured or evennot transparent, however transparency allows continuously monitoring ofthe irrigation. Also the waste collection bag 3 may be provided with ameans, such a handle (not shown), for facilitating transportation andsuspending of the waste collection bag 3.

The rectal catheter 4 consists of a coupling end 19 extending into atapering cylinder 20 to be inserted into the rectum of a patient throughthe anus. The rectal catheter 4 is hollow to allow evacuation from theintestine into the waste collection bag 3. At the coupling end 19, therectal catheter has a circumferential flange part 21 for engaging thebore 12 of the first coupling part 8. The flange part 21 fits sealinglyinto the bore 12 enabling evacuation of irrigation liquid and intestinalwaste material without spillage and leakage. For facilitating handlingof the rectal catheter 4 during engaging and disengaging the firstcoupling part 8 the flange part 21 has opposing protruding flaps or ears22,23. The tapering cylinder 20 of the rectal catheter 4 has a feedingbranch 24 for an infusing irrigation liquid from a reservoir (notshown).

Alternatively the feeding branch can be provided in any of the first andthe second coupling parts and a clamp be used for opening and closingsupply of irrigation liquid.

The reservoir may be of any suitable kind including open and closedreservoirs, and the irrigation liquid can e.g. be water, saline or anyof these including a medical compound promoting dissolution of solidmatter in the intestine, promoting peristaltic, or the medical compoundmay be a drug or medicament beneficial for the intestine, or the patientin general.

The introducer 2 is configured with a pointed but still blunt tip 25, ahandle 26 and a guide rod 27 extending between the tip 25 and the handle26. The blunt tip 25 has a greatest diameter that corresponds theinternal diameter of the free, open end 28 of the cylinder 20 of therectal catheter 3. The tip of the introducer 2 is dimensioned so thatthe introducer 2 is held in frictional, force-fitting engagement insidethe rectal catheter 4 to ensure that the rectal catheter 4 and theintroducer 2 remains secured to each other during insertion.

As seen best in FIG. 2 the introducer 2 are inserted into the rectalcatheter 4 so that the tip 25 of the introducer 2 protrudes from theopen, free end 28 of the catheter 4. The location of the introducerinside the rectal catheter 4 is indicated in dotted line. Both theintroducer 2 and the rectal catheter 4 are made of an inexpensive,disposable plastic material. The introducer 2 is optional and the rectalcatheter 4 can quite as well be inserted into the rectum without usingan introducer 2.

The dimensionally stable rectal catheter 4 housing or not housing theintroducer 2 is preferably greased on the exterior face to reducefrictional force during insertion into the rectum.

In use the tip 25 and/or the open free end 28 of the rectal catheter 4is pointed towards the anus, and the rectal catheter is gently forcedinside the rectum. If an introducer 2 is used it is removed and the bore12 of the tubular connection piece 16 of the first coupling part 8 ismounted around the flange part 21 of the rectal catheter 4, as indicatedwith the arrow A, to seal the coupling between the rectal catheter andthe waste collection bag. Next, as indicated with the arrow B in FIG. 3the male part 10 of the second coupling part 7 are inserted into thebore 12 of the first coupling part 8 or into the flange part 21 of therectal catheter 4 from the opposite side to effectively block the accessof irrigation liquid to the waste collection bag 3 during infusion. Thisassembled state is seen best in FIG. 4.

An irrigation source (not shown) is connected to the inlet opening, thefeeding branch 24, to establish liquid communication to the intestine,as indicated with the arrow C in FIG. 4. The amount of available infusedirrigation liquid may vary but can e.g. be 2000 ml app. 38° C. water ofwhich for example about 500-1000 ml are infused before evacuation isstarted. Infusion may be facilitated by a pump, pressing on theirrigation liquid container, preferably a plastic waste collection bag,or may simply take place using gravity. How to infuse is of the choiceof the operator or the patient. If desired the procedure can be repeatedusing a portion of the remaining available irrigation liquid, providedthe waste collection bag 3 is not full yet or is emptied.

For evacuation the male part 10 of the second coupling part 7 is pulledout of the bore 12 of the first coupling part 8 or of the flange part 21of the rectal catheter 4, as indicated with the arrows D in FIG. 5 andthe infused irrigation liquid and suspended or softened intestinalmaterial 29 is allowed to flow freely from the intestines into the wastecollection bag 3 until at least substantially complete evacuation isreached.

The male part 10 of the second coupling part 7 are reinserted into thebore 12 of the female first coupling part 8 to close the full wastecollection bag 3, as indicated with the arrow seen in FIG. 6. Optionallythe rectal catheter 4 is disengaged and both the rectal catheter 4 andthe closed waste collection bag 3 are ready for disposal.

The rectal catheter may or may not be separated from the first couplingpart leaving behind the closed waste collection bag, which now appearsas an easy disposable unit.

Suitable exterior diameters for standard rectal catheters are between8-35, and suggested standard diameter are for example about 10-11 mm,20-21 mm or 30-31. The reservoir for irrigation liquid is preferablysuspended at a dropstand or similar means that provide distance betweenthe location of the device and the reservoir that provides forappropriate infusion speed and rate, preferably using gravity. Thereservoir may be equipped with a tube for connecting to the rectalcatheter 4. Furthermore, the reservoir can be capped to allow forfilling it to any desired degree, e.g. with lukewarm tap water.

FIG. 7 shows in an enlarged scale an axial, sectional view of a firstway of engaging a first coupling 8, a second coupling part 7 and arectal catheter 4, as described for the preceding FIGS. 1-6. Thecircumferential flange part 21 of the coupling end 19 of the rectalcatheter 4 is seen inserted into the bore 12 of the first coupling part8, and the male part 10 is inserted inside the circumferential flangepart 21 of the rectal catheter 4. In this embodiment the flange part 21of the rectal catheter 4 serves as a tight seal between the firstcoupling part 8 and the second coupling part 7.

In a modified embodiment the exterior diameter of the second couplingpart 7's male part 10 and the circumferential flange part 21 of therectal catheter 4 may be substantially identical, in which case a tightseal is obtained by selecting the internal diameter of the tubularconnection piece 16 of the first coupling part 8 to be substantially thesame.

FIG. 8 shows in an enlarged scale an axial, sectional view of a secondway of engaging a first coupling part 8′, a second coupling part 7′ anda rectal catheter 4. The embodiment shown in FIG. 8 correspondssubstantially to the embodiment shown in FIG. 7 and for like parts likenumerals are used.

The first coupling part 8′ has a first short tubular extension 30extending inside the waste collection bag 1 and the second coupling part7′ has a mating second tubular extension 31 fitting tightly andsealingly around the first tubular extension. In this embodiment therectal catheter can be detached without the waste collections bag 3subsequently leaks.

If the first and second coupling parts are disengaged from each otherthe evacuated content in the waste collection can in a simple mannerempty into the toilet using the rectal catheter as an outlet canal orspout.

Various outlet means allowing hygienic emptying of the device afterevacuation may be provided on e.g. the coupling parts or in the walls ofthe waste collection bag.

FIG. 9 shows a sectional view of a second embodiment 32 of an intestinalirrigation device according to the present invention. The intestinalirrigation device 32 corresponds substantially to the intestinalirrigation device 1 according to the previously described embodiment andfor like parts same reference numerals are used.

The second embodiment of the intestinal irrigation device 32 has asecond wall 6 with a first coupling part 8, a first wall 5 with a secondcoupling part 7, through both of which parts 7,8 a guide rod 27 of amodified introducer 2′ extends. The tip 25 of the introducer 2′ isretractable positioned inside both the bag 3, the tapered tubular part20′ of the rectal catheter 4′ and a through-opening 33 of the secondcoupling part 7. The tip 25 fits lengthwise movable inside the tubularpart 20′ so that when the tip 25 is pushed forward against the firstcoupling part 8 and further inside the tapered tubular part 20′ of thecatheter 4′, the tip 25 can protrude from the free end of the tubularpart 20′ to facilitate insertion of the catheter 4′ into the rectum.Optionally the design of the tip also enhances sealing between catheter4′ and bag 3. Opposite the tip 25 the guide rod 2′ of the introducer 2′extends through the through-going opening 33 of the second coupling part7 into a handle 26 serving for displacing either the introducer 2′, theintroducer 2′ and the second coupling part 7 together, or the introducer2′ and the second coupling part 7 individually, in and out of the rectalcatheter and the first coupling part 7,8 for among other things closingthe bag during infusion of irrigation liquid via inlet opening 24, andopening of the bag during irrigation when the first 8 and the secondcoupling part 7 are disengaged.

Hence, in this embodiment 32 the introducer 2′ can be moved as aseparate part through both the second coupling part 7 and the rectalcatheter 4′, and the engagement and disengagement of the coupling parts7,8 are made in a separate action by grasping the externally protrudingannular flange 34 of the second coupling part 7 and moving thesecoupling parts 7,8 towards or against each other, optionally only movingone of the coupling parts 7,8. The through-opening 33 surrounds theguide rod 25 in a fluid tight, optionally frictional manner which alsoserves the purpose of preventing unintentional moving of the introducerduring insertion of the catheter into the rectum.

Modifications and combinations of the above principles and designs areforeseen within the scope of the present invention.

The novel devices provide a time saving alternative to known devices, inthat the procedure need not take more than 15-20 minutes and no odouremissions and unpleasant smell is recognized during the irrigationprocedure.

1.-11. (canceled)
 12. An intestinal irrigation device comprising: awaste collection bag having a first wall circumferentially united withan opposing second wall and an inlet opening for irrigated waste; and arectal catheter having a first end for coupling with the wastecollection bag and a free end for insertion into the rectum, wherein theinlet opening has a first coupling part for coupling the rectal catheterinto fluid communication with the waste collection bag, and the wastecollection bag has a second coupling part inside the waste collectionbag for mating the first coupling part.
 13. The intestinal irrigationdevice according to claim 12, wherein the inlet opening is provided inthe second wall, and the second coupling part protrudes inside the wastecollection bag from the first wall substantially opposite the inletopening.
 14. The intestinal irrigation device according to claim 12,wherein the first coupling part is a female tubular first coupling parthaving a part designed to receive the rectal catheter, which partsurrounds or fits into an annular part of a second coupling part whichis operable from outside the waste collection bag to engage with thefemale tubular first coupling part.
 15. The intestinal irrigation deviceaccording to claim 12, wherein the rectal catheter or the secondcoupling part sealingly engages the first coupling part.
 16. Theintestinal irrigation device according to claim 12, wherein the rectalcatheter is detachably attached to the first coupling part.
 17. Theintestinal irrigation device according to claim 12, wherein the rectalcatheter is a dimensionally stable, tubular structure which has an inletopening for infusing the irrigation liquid.
 18. The intestinalirrigation device according to claim 12, wherein the rectal catheter hasa tapered end.
 19. The intestinal irrigation device according to claim12, which further comprises an introducer for inserting the rectalcatheter into the rectum.
 20. The intestinal irrigation device accordingto claim 19, wherein the introducer has a tip and a guide rod whichextends displaceably through the second coupling part with the tip ofthe introducer inside the bag.
 21. A method of applying the intestinalirrigation device according to claim 1 to a subject, which methodcomprises: inserting the rectal catheter in the rectum; mating thecoupling parts to at least substantially close the waste collection bagbag; mounting the substantially closed waste collection bag on therectal catheter; infusing the irrigation liquid to at least the rectumintestine, disengaging the first coupling part and the second couplingpart; draining the irrigation liquid and irrigated intestinal contentinto the waste collection bag; removing the rectal catheter from therectum; and engaging the second coupling part into the first couplingpart to close the inlet opening of the waste collection bag.
 22. Themethod according to claim 21, wherein the rectal catheter is detachedfrom the closed waste collection bag before disposal.